Principles of Tendon Transfers

1. All joints on which the transfer is to work should have full PROM.

2. Transfer should not cause loss of an essential muscle function.

3. Any muscle loses at least 1 grade of strength with transfer.

4. Muscle excursion should be matched, taking into account 2-3 cm tenodesis action with wrist motion - usually contraindicates wrist fusion for paraplegics.

5. Take into account the effect of remaining joint motion on the force generated by the transfer.

6. Avoid acute angulation of the transferred tendon.

7. Usually attach transferred muscle to the tendon of the motor end to end if no native recovery anticipated; end to side if recovery anticipated.

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